Oral lesions in Brazilian HIV-infected children undergoing HAART

The advent of new antiretroviral drugs such as protease inhibitors (PI) has generated sensible changes in oral manifestation patterns in human immunodeficiency virus (HIV) infected adult patients.

The purpose of the present study was to assess whether the use of highly active antiretroviral therapy (HAART) has brought changes to pattern and prevalence of oral lesions related to HIV in the HIV-infected pediatric population.

We analyzed medical charts of 471 children aged zero to 12 years and 11 months with HIV infection and followed up by the Ambulatory of AIDS, Clinical Otorhinolaryngology, Hospital das Clinicas, Medical School, Sao Paulo University, from January 1990 to December 2004. Four hundred and fifty-nine children were divided into two groups, according to age range: X (0-5 years and 11 months) and Y (6-12 years and 11 months). These groups were subdivided into four subgroups, according to use of ART (antiretroviral therapy without PI) or HAART. We recorded data related to type of oral lesion presented, as well as serum CD4+ lymphocyte count. The groups were compared concerning prevalence and presentation pattern of oral manifestations.

Out of 459 children, 144 (31.4%) had oral lesions. We observed that in children aged 6-12 years and 11 months who were taking HAART, there was lower prevalence of oral lesions (p=0.005), specially hairy leukoplakia (p<0.02), without any affection to the common presentation pattern of these lesions. The same subgroup also had higher serum CD4+ lymphocyte counts (p<0.001).

We concluded that use of HAART could lead to reduction in prevalence of oral lesions in HIV-infected children.